Nuclear magnetic differential diagnosis of acute bilirubin encephalopathy and neonatal hypoxic-ischemic encephalopathy / 中华实用儿科临床杂志

ABSTRACT

Objective To provide more objective evidence for clinical differential diagnosis of the neonatal hypoxic-ischemic encephalopathy(HIE) and acute bilirubin encephalopathy(ABE) by reviewing the magnetic resonance imaging differences between them.Methods The MRI findings along with T1WI characteristics in 48 neonates with HIE and in 36 neonates with ABE in two Grade Ⅲ Class A hospitals between Jan.2010 and Jan.2012 were retrospectively reviewed.All of the MRI imaging data were read again by 2 professor neuroradiologist from these hospital by blind method,and the results were analyzed by the SPSS 15.0 statistical analysis software.Results The ABE in the MRI examination exhibited more abnormalities (OR =29.62,95 ％ CI7.74-113.38),the difference was statistically significant(x2 =34.636,P =0.000) ; Putamen signals changes were more observed clearly in the HIE,and compared with those in ABE patients,the difference was statistically significant (x2 =4.838,P =0.028) ;the performance of the globus pallidus signals changes in ABE neonates were more observed (OR =24.27,95％ CI7.68-76.68),and compared with those in HIE neonates,the difference was statistically significant (x2 =36.560,P =0.000).Subthalamic signal changes were found most in ABE neonates (OR =16.43,95 ％ CI3.44-78.442),the difference was statistically significant(x2 =17.921,P =0.000).And the ABE globus pallidus,subthalamic high signal was localized,with a clear boundary,and high signal intensity on HIE diffusion,and edge blur.Conclusions The globus pallidus,subthalamic of neonates with ABE more easily demonstrated high signal,the putamen in neonates with HIE more easily demonstrated high signal;injury induced by ABE is limited,the damage area with clear boundary,HIE damage is more dispersed,the boundary is not clear.